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General NPI Number Information
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NPI Number | 1902971823
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Entity Type | Individual
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Provider Name | GEORGE E NAGEL MSW
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Gender | Male
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Dates
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Enumeration Date | 11/24/2006
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Last Update Date | 05/28/2022
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Provider Practice Location Address
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Address Line | 12936 SE ELDERBERRY DR
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City | SOUTH BEACH
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State | OR
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Zip | 97366-9502
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Country | US
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Telephone | 541-272-0893
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 320
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City | SILETZ
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State | OR
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Zip | 97380-0320
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Country | US
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Telephone | 541-444-1030
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Fax | 541-444-9678
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L1616
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License Number State | OR
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